Provider Demographics
NPI:1538137880
Name:REO, ROBERT SALVATORE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:SALVATORE
Last Name:REO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 SHREWSBURY AVE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4183
Mailing Address - Country:US
Mailing Address - Phone:732-345-3429
Mailing Address - Fax:732-345-3401
Practice Address - Street 1:661 SHREWSBURY AVE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4183
Practice Address - Country:US
Practice Address - Phone:732-345-3429
Practice Address - Fax:732-345-3401
Is Sole Proprietor?:No
Enumeration Date:2006-03-11
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC048168001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical